Basindwah Sarah A, Alzahrani Basmah S, Ajlan Abdulrazag M, Alkhalidi Hiasham
Department of Surgery, Division of Neurosurgery, King Saud University, Riyadh, Saudi Arabia.
Department of Surgery, Imam Abdulrahman Bin Faisal University, Al-Khobar, Eastern Province, Saudi Arabia.
Surg Neurol Int. 2021 Sep 30;12:483. doi: 10.25259/SNI_681_2021. eCollection 2021.
Hydrocephalus is the most common presentation of choroid plexus tumors; it is thought to be caused either by mass effect obstructing the cerebrospinal fluid pathways or secretory properties of the tumor. In these case reports, we present two cases of choroid plexus tumors with persistence of communicating hydrocephalus postoperatively and review similar reports in the literature.
Case 1: a 2-month-old baby girl presented with bulging fontanelle, sunsetting eyes. Magnetic resonance imaging (MRI) showed large third ventricle mass with communicating hydrocephalus. She underwent complete excision of tumor through transcortical approach with perioperative intraventricular hemorrhage. Hydrocephalus persisted postoperatively and the patient required permanent ventriculoperitoneal (VP) shunt. Case 2: a 16-year-old boy presented decreased visual acuity, papilledema, and morning headaches. MRI showed a tumor in the right ventricle and communicating hydrocephalus. He underwent transparietal resection of the tumor. In both cases, hydrocephalus persisted postoperatively and patients required permanent VP shunt. Review of similar cases showed the majority of cases required permanent shunting.
Choroid plexus tumor patients can present with communicating hydrocephalus that may persist post tumor resection for different etiologies. Careful follow-up to determine the need for cerebrospinal fluid diversion through a permanent VP shunt is important.
脑积水是脉络丛肿瘤最常见的表现形式；其被认为是由阻塞脑脊液通路的占位效应或肿瘤的分泌特性所致。在这些病例报告中，我们呈现了两例脉络丛肿瘤患者，术后交通性脑积水持续存在，并回顾了文献中的类似报告。
病例1：一名2个月大的女婴，表现为囟门膨隆、落日征。磁共振成像（MRI）显示第三脑室有巨大肿块伴交通性脑积水。她通过经皮质入路接受了肿瘤全切术，术中出现脑室出血。术后脑积水持续存在，患者需要永久性脑室腹腔（VP）分流术。病例2：一名16岁男孩，表现为视力下降、视乳头水肿和晨起头痛。MRI显示右脑室有一个肿瘤及交通性脑积水。他接受了经顶叶肿瘤切除术。在这两个病例中，术后脑积水均持续存在，患者均需要永久性VP分流术。对类似病例的回顾显示，大多数病例需要永久性分流。
脉络丛肿瘤患者可出现交通性脑积水，术后可能因不同病因持续存在。通过仔细随访以确定是否需要通过永久性VP分流术进行脑脊液分流很重要。
